Professional Documents
Culture Documents
Description: Tags: 2004-235a
Description: Tags: 2004-235a
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CLOSING DATE: SEPTEMBER 13, 2004
TABLE OF CONTENTS
SUBJECT SECTION
Selection Criteria D
Important Notices F
• Important Points to Remember
• New Provision in the Department of Education’s General Education
Provisions Act (GEPA)
• The Government Performance and Results Act (GPRA)
• Notice Regarding Executive Order 12372 and Listing of State Single
Points of Contact
• Important Notice to Prospective Participants/USDE Grant and Contract
Programs
• Regional Offices Listing
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Section A
Dear Applicant Letter
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Dear Applicant:
The Secretary invites applications for new awards for fiscal year (FY) 2004
under the Special Demonstration Programs, Model Demonstration Projects,
Positive Psychology, (CFDA 84.235A). This program is authorized by the
statutory authority contained in Part 303 (b) of the Rehabilitation Act of
1973, as amended. (29 U.S.C. 773 (b)).
PROGRAM PURPOSE
APPLICATION PROCEDURES
Applicants must submit one original application and two copies. The
Rehabilitation Services Administration would appreciate receiving three
additional copies to facilitate the peer review process, (six applications in
all).
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Street, SW, Potomac Center Plaza, Room 7041, Washington, DC 20202-
4260. Phone number 202-245-6288.
APPLICATION CONTENT
Block number 4 of the application cover page (Standard Form 424) requires
that the appropriate CFDA be inserted. For this application, use CFDA
number 84.235A with the title of the program as Special Demonstration
Programs, Model Demonstration Projects, Positive Psychology.
Each proposal must include a one page abstract. The abstract is a critical
component of the proposal and must highlight the purpose of the project,
target population to be served during the project period, planned goals and
objectives, strategies utilized, and project outcomes.
The program narrative must address the selection criteria used for this
program that are included in this application kit (Section D). In addition
when addressing the selection criteria for “Quality of the Project
Evaluation,” we strongly suggest you develop an evaluation that will
demonstrate the impact of the project. The Office of Management and
Budget (OMB) website may offer suggestions for the design of the
evaluation component. You may access this information at:
http://www.whitehouse.gov/omb/part/2004_program_eval.pdf .
To facilitate the peer review process, applicants are encouraged to address
the criteria in the order presented.
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PROGRAM RULES AND REGULATIONS
The subsequent program regulation 34 CFR part 373, is found in this kit.
Please review the regulation and NOTE an indirect cost rate requirement.
Indirect costs are limited to the recipient’s actual negotiated indirect cost
rate, or 10% of the total direct cost base, whichever amount is less. (The
limit does not apply to federally recognize Indian tribal governments.)
(§373.4)
E-APPLICATION REQUIREMENTS
If you use e-Application, you will be entering data online while completing
your application. You may not e-mail an electronic copy of a grant
application to us. If you participate in this voluntary pilot project by
submitting an application electronically, the data you enter online will be
saved into a database. We request your participation in e-Application and if
you utilize this method please see instructions in the Notice Inviting
Application under Part III, “Other Submission Requirements.” We shall
continue to evaluate its success and solicit suggestions for its improvement.
TECHNICAL ASSISTANCE
If you have any questions about the information in this application kit,
please contact Alfreda Reeves at (202) 245-7485. Individuals who use a
telecommunications device (TDD) may call the Federal Information Relay
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Services (FIRS) at 1-800-877-8339 between 8:00 a.m. and 8:00 p.m.,
Eastern Standard Time, Monday through Friday.
Sincerely,
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Section B
Notice Inviting Applications for New Awards
and Notice of Final Priority
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4000-01-U
DEPARTMENT OF EDUCATION
Overview Information
Projects--Positive Psychology
(FY) 2004.
84.235A
Dates:
2004.
education.
FY 2004.
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Maximum Award: We will reject any application that
Federal Register.
Number of Awards: 1.
notice.
activities.
Federal Register.
application requirements.
10
The priority, definitions, and application
requirements are:
74, 75, 77, 79, 80, 81, 82, 84, 85, 86, 97, and 99. (b) The
FY 2004.
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change the maximum amount through a notice published in the
Federal Register.
Number of Awards: 1.
notice.
of higher education.
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If you request an application from ED Pubs, be sure to
8339.
standards:
13
•A “page” is 8.5” x 11”, on one side only, with 1”
2004.
14
Applications for grants under this competition may be
of this notice.
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6. Procedures for Submitting Applications:
delivery.
following:
Grants Web site are 6:00 a.m. Monday until 7:00 p.m.
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for maintenance, Washington, DC time. Any modifications to
package.
format.
your application).
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2. The applicant’s Authorizing Representative must sign this
form.
(202) 245-6272.
date; or
for any period of time between 3:30 p.m. and 4:30 p.m.,
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We must acknowledge and confirm these periods of
grants.ed.gov
the following:
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2. A legible mail receipt with the date of mailing
commercial carrier; or
Secretary of Education.
of mailing:
Postal Service.
the application.
post office.
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Application Control Center
Attention: (CFDA Number 84.235A)
550 12th Street, SW.
Room 7041, Potomac Center Plaza
Washington, DC 20202-4260
the building.
Department:
from the mailing of your application, you should call the U.S.
245-6288.
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VI. Award Administration Information
notice.
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We reference the regulations outlining the terms and
relate to the intended outcomes and goals and that are used
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Demonstration Grants, OMB# 1820-0646, an electronic grantee
reporting system.
(FIRS) at 1-800-877-8339.
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(GPO), toll free, at 1-888-293-6498; or in the Washington,
at: www.gpoaccess.gov/nara/index.html
Dated:
________________________________
Troy R. Justesen,
Acting Deputy Assistant Secretary
for Special Education and
Rehabilitative Services.
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4000-01-U
DEPARTMENT OF EDUCATION
RIN 1820-ZA35
Projects--Positive Psychology
application requirements.
subjective well-being.
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EFFECTIVE DATE: This priority, these definitions, and
2004.
Alfreda.Reeves@ed.gov
(FIRS) at 1-800-877-8339.
contact person
SUPPLEMENTARY listed under
INFORMATION: TheFOR FURTHER for
authority INFORMATION
these projects
373.
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Positive psychology is the study and practice of
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Research in positive psychology has yielded a variety
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system. The priority supports section 303(b) by furthering
forWeemployment,
published aand subjective
notice well-being.
of proposed priority,
the following:
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2. The applicant must address all three positive
psychology techniques.
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and underserved populations, if these populations reside
this priority.
characteristic factors.
32
demonstrate the effectiveness of the specific positive
Change: None.
Change: None.
33
Comment: One commenter suggested that the subjective well-
a solitary outcome.
Change: None.
34
talents for employment, and SWB. Applicants may include a
Change: None.
design.
Change: None.
unclear.
35
Discussion: We agree that there should be clarity in
priority.
75.105(c)(3)).
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meets the competitive priority over an application of
comparable merit that does not meet the priority (34 CFR
75.105(c)(2)(ii)).
PRIORITY:
Priority, Definitions, and Application Requirements--Model
psychology methods.
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A. Definitions
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with each required technique. An applicant must be
outcomes;
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strategies and meaningful postsecondary education and
employment outcomes;
Intergovernmental Review
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governments for coordination and review of proposed Federal
financial assistance.
www.ed.gov/news/fedregister
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access to the official edition of the Federal Register and
at:
http://www.gpoaccess.gov/nara/index.html
Projects--Positive Psychology)
Dated:
______________________
Troy R. Justesen,
Acting Deputy Assistant
Secretary for Special
Education and Rehabilitative
Services.
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Section C
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PART 373—SPECIAL DEMONSTRATION PROGRAMS
Subpart A--General
Sec.
373.1 What is the purpose of the Special Demonstration
Programs?
373.2 Who is eligible for assistance?
373.3 What regulations apply?
373.4 What definitions apply?
373.5 Who is eligible to receive services and to benefit
from activities conducted by eligible entities?
373.6 What are the priorities and other factors and
requirements for competitions?
information?
Subpart A--General
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provision of rehabilitation and other services authorized under the
Rehabilitation Act of 1973, as amended (Act), or to further the
purposes and policies in sections 2(b) and (c) of the Act by supporting
activities that increase the provision, extent, availability, scope, and
quality of rehabilitation services under the Act, including related
research and evaluations activities.
(Authority: 29 U.S.C. 701(b) and (c), 711(c), and 773(b))
§373.2 Who is eligible for assistance?
(a) The following types of organizations are eligible for assistance
higher education.
(6) Consortia that meet the requirements of 34 CFR 75.128 and 75.129.
(7) Other organizations identified by the Secretary and published in the Federal
Register.
(b) In competitions held under this program, the Secretary may limit competitions
follows:
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(2) 34 CFR part 75 (Direct Grant Programs).
(Grants)).
(c) The regulations in 48 CFR part 31 (Contracts Cost Principles and Procedures).
adults with disabilities designed to begin the rehabilitation services as soon as possible
populations served may include, but are not limited to, the following:
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(a) Individuals with chronic and progressive diseases that may become more
(b) Individuals in the acute stages of injury or illness, including, but not limited
to, diabetes, traumatic brain injury, stroke, burns, or amputation. (Authority: 29 U.S.C.
711(c))
(a) For an individual who will receive rehabilitation services under this part, an
(1) Who has a physical or mental impairment which, for that individual,
rehabilitation services.
(b) For all other purposes of this part, an individual with a disability means an
individual--
(1) Who has a physical or mental impairment that substantially limits one or more
(c) For purposes of paragraph (b) of this definition, projects that carry out services
or activities pertaining to Title V of the Act must also meet the requirements for “an
individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable.
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(a) Who has a severe physical or mental impairment that seriously limits one or
(c) Who has one or more physical or mental disabilities resulting from
amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis,
paraplegia, quadriplegia and other spinal cord conditions, sickle-cell anemia, specific
disabilities served by projects under this part have the opportunity to be active, full
follows:
outcomes, entities providing these services, and the methods used to secure these
services.
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Rehabilitation services means services provided to an individual with a disability
interests, and informed choice of the individual. Rehabilitation services for an individual
rehabilitation technology;
(b) Counseling and guidance, including information and support services to assist
(c) Referral and other services to secure needed services from other agencies;
(d) Job-related services, including job search and placement assistance, job
(e) Vocational and other training services, including the provision of personal and
(g) Maintenance for additional costs incurred while the individual is receiving
services;
(h) Transportation;
(l) Occupational licenses, tools, equipment, and initial stocks and supplies;
analysis, develop business plans, and otherwise provide resources to eligible individuals
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who are pursuing self-employment or telecommuting or establishing a small business
(o) Transition services for individuals with disabilities that facilitate the
(q) Services to the family of an individual with a disability necessary to assist the
in creating new jobs and career advancement options in local job markets through the use
(4) Other services as identified by the Secretary and published in the Federal
Register.
other related factors) hinders an individual from preparing for, entering into, engaging in,
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(Authority: 29 U.S.C. 705(20)(A))
Youth or Young adults with disabilities means individuals with disabilities who
are between the ages of 16 and 26 inclusive when entering the program.
§373.5 Who is eligible to receive services and to benefit from activities conducted by
eligible entities?
(a)(1) For projects that provide rehabilitation services or activities to expand and
improve the provision of rehabilitation services and other services authorized under Titles
I, III, and VI of the Act, individuals are eligible who meet the definition in paragraph (a)
(2) For projects that provide independent living services or activities, individuals
are eligible who meet the definition in paragraph (b) of an “individual with a disability”
as stated in §373.4.
(3) For projects that provide other services or activities that further the purposes
of the Act, individuals are eligible who meet the definition in paragraph (b) of an
(b) By publishing a notice in the Federal Register, the Secretary may identify
individuals determined to be eligible under one or more of the provisions in paragraph (a)
of this section.
§373.6 What are the priorities and other factors and requirements for competitions?
(a)(1) In making an award, the Secretary may limit competitions to, or otherwise
give priority to, one or more of the priority projects listed in paragraph (b) of this section
that are identified by the Secretary and published in a notice in the Federal Register.
(2) The Secretary also will identify in the notice the following:
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(i) Specific required priority project activities authorized under section 303 of the
Act that the applicant must conduct for the priority project to be approved for funding.
(ii) Any of the additional factors listed in paragraph (c) of this section that the
(7) Replication.
(8) Special projects and demonstration of service delivery for adults who are low-
(10) Model transitional rehabilitation services for youth and young adults with
disabilities.
§373.4.
employment-related services under Title I of the Workforce Investment Act of 1998 and
outcomes.
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(14) The demonstration of the effectiveness of early intervention activities in
(16) Other projects that will expand and improve the provision, extent,
availability, scope, and quality of rehabilitation and other services under the Act or that
further the purpose and policy of the Act as stated in section 2(b) and (c) of the Act.
(c) The Secretary may identify and publish in the Federal Register for specific
projects listed in paragraph (b) of this section one or more of the following factors,
including any specific elements defining any factor (e.g., the Secretary may identify ages
Enterprise Communities.
(d) The Secretary may require that an applicant certify that the project does not
include building upon or expanding activities that have previously been conducted or
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(e) The Secretary may require that the project widely disseminate the methods of
rehabilitation agencies and other disability organizations in the project’s targeted service
package the selection criteria for each competition under this program. To evaluate the
applications for new grants under this program, the Secretary may use the following:
(c) Any combination of selection criteria from paragraphs (a) and (b) of this
section.
§373.11 What other factors does the Secretary consider when making a grant?
(b) The Secretary may consider the past performance of the applicant in carrying
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§373.20 What are the matching requirements?
The Secretary may make grants to pay all or part of the cost of activities covered
under this program. If the Secretary determines that the grantee is required to pay part of
the costs, the amount of grantee participation is specified in the application notice, and
the Secretary will not require grantee participation to be more than 10 percent of the total
(a) In addition to the program and fiscal reporting requirements in EDGAR that
are applicable to projects funded under this program, the Secretary may require that
recipients of grants under this part submit information determined by the Secretary to be
necessary to measure project outcomes and performance, including any data needed to
(a) Indirect cost reimbursement for grants under this program is limited to the
recipient’s actual indirect costs, as determined by its negotiated indirect cost rate
agreement, or 10 percent of the total direct cost base, whichever amount is less.
(b) Indirect costs in excess of the 10 percent limit may be used to satisfy matching
or cost-sharing requirements.
(c) The 10 percent limit does not apply to federally recognized Indian tribal
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§373.23 What additional requirements must be met?
(1) Ensure equal access and treatment for eligible project participants who are
members of groups that have traditionally been underrepresented based on race, color,
(2) Encourage applications for employment from persons who are members of
groups that have traditionally been underrepresented based on race, color, national origin,
(3) Advise individuals with disabilities who are applicants for or recipients of the
(4) Provide, through a careful appraisal and study, an assessment and evaluation
of the project that indicates the significance or worth of processes, methodologies, and
(b) A grantee may not make a subgrant under this part. However, a grantee may
contract for supplies, equipment, and other services, in accordance with 34 CFR part 74,
§373.24 What are the special requirements pertaining to the protection, use,
and release of personal information?
(a) All personal information about individuals served by any project under this
part, including lists of names, addresses, photographs, and records of evaluation, must be
confidential.
(b) The use of information and records concerning individuals must be limited
only to purposes directly connected with the project, including project reporting and
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evaluation activities. This information may not be disclosed, directly or indirectly, other
than in the administration of the project unless the consent of the agency providing the
information and the individual to whom the information applies, or his or her
representative, has been obtained in writing. The Secretary or other Federal officials
responsible for enforcing legal requirements have access to this information without
written consent being obtained. The final products of the project may not reveal any
personal identifying information without written consent of the individual or his or her
representative.
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Sec. 303 Demonstration and Training Programs
A grant or contract under paragraph (1) shall contain such terms and
conditions as the Commissioner may require.
(3) Application
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The programs that may be funded under this subsection may include--
(A) In general
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(vi) The needs of underserved populations, unserved and underserved
areas, individuals with significant disabilities, low-incidence disability
population or individuals residing in federally designated
empowerment zones and enterprise communities.
The Commissioner may use funds made available to carry out this
section for continuation awards for projects that were funded under
sections 12 and 311 (as such sections were in effect on the day before
the date of the enactment of the Rehabilitation Act Amendments of
1998).
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Section D
Selection Criteria
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SPECIAL DEMONSTRATION PROGRAMS
MODEL DEMONSTRATION PROJECTS—POSITIVE PSYCHOLOGY (84.235A)
Selection Criteria for Applications
(Taken from 34 CFR 75.209 and 210)
(B) The maximum score for all of these criteria is 100 points.
(D) Because no points are assigned to the selected factors within each
criterion, the Secretary evaluates each factor within each criterion
equally.
The Secretary considers the application requirements for the proposed model
demonstration project based on the following factors:
(i) The extent to which the model demonstrates the adaptation of the
three positive psychology techniques for use by VR professionals.
(ii) The extent to which the application demonstrates that techniques
will lead to increased postsecondary education and employment outcomes of
VR consumers.
(iii) The likelihood that the proposed project strategies will lead to
increased employment outcomes of VR consumers.
(iv) The extent to which the application demonstrates a plan to
widely disseminate the results of the project, including any model proven to
be effective, so the model may be adapted, replicated or integrated by State
vocational rehabilitation agencies and other disability organizations.
The Secretary considers the need for the proposed project based on the
following factor:
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the proposed project, including the nature and magnitude of those gaps or
weaknesses.
The Secretary considers the quality of the design of the proposed project
based on the following factors:
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(ii) The extent to which the design of the proposed project is appropriate
to, and will successfully address, the needs of the target population or other
identified needs.
(iii) The extent to which there is a conceptual framework underlying the
proposed research or demonstration activities and the quality of that
framework.
(iv) The quality of the proposed demonstration design and procedures for
documenting project activities and results.
(v) The extent to which the design for implementing and evaluating the
proposed project will result in information to guide possible replication of
project activities or strategies, including information about the effectiveness
of the approach or strategies employed by the project.
(vi) The extent to which the proposed project is designed to build
capacity and yield results that will extend beyond the period of Federal
financial assistance.
(vii) The extent to which the design of the proposed project reflects up-
to-date knowledge from research and effective practice.
(viii) The extent to which the propose project represents an exceptional
approach to the priority established for the competition.
(viiii) The extent to which the proposed project will establish linkages
with other appropriate agencies and organizations providing services to the
target population.
(x) The extent to which performance feedback and continuous
improvement are integral to the design of the proposed project.
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(iv) The extent to which the services to be provided by the proposed
project involve the collaboration of appropriate partners for maximizing the
effectiveness of project services.
The Secretary considers the quality of the personnel who will carry out the
proposed project based on the following factors:
The Secretary considers the adequacy of resources for the proposed project
based on the following factors:
The Secretary considers the quality of the management plan for the proposed
project based on the following factor:
(i)The adequacy of the management plan to achieve the objectives of
the proposed project on time and within budget, including clearly defined
responsibilities, timelines, and milestones for accomplishing project tasks.
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(9) Quality of the project evaluation. (15 points)
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Section E
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INSTRUCTIONS FOR TRANSMITTING APPLICATIONS
If you want to apply for a grant and be considered for funding, you must meet the
following deadline requirements:
You must submit your grant application through the Internet using the software provided on the e-
Grants Web site (http://e-grants.ed.gov) by 4:30 p.m. (Washington, DC time) on the application
deadline date. The regular hours of operation of the e-Grants website are 6:00 a.m. Monday until
7:00 p.m. Wednesday; and 6:00 a.m. Thursday until midnight Saturday (Washington, DC time).
Please note that the system is unavailable on Sundays, and after 7:00 p.m. on Wednesdays for
maintenance (Washington, DC time). Any modifications to these hours are posted on the e-Grants
Web site.
If you submit your application through the Internet via the e-Grants Web site, you will receive an
automatic acknowledgment when we receive your application.
You must mail the original and two copies of the application on or before the
deadline date to the address below. To help expedite our review of your
application, we would appreciate you voluntarily including an additional three
copies of your application.
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(2) A legible mail receipt with the date of mailing stamped by the U. S. Postal Service.
(3) A dated shipping label, invoice, or receipt from a commercial carrier.
(4) Any other proof of mailing acceptable to the Secretary.
If you mail an application through the U.S. Postal Service, we do not accept either
of the following as proof of mailing:
An applicant should note that the U.S. Postal Service does not uniformly provide a dated
postmark. Before relying on this method, an applicant should check with its local post office.
Special Note: Due to recent disruptions to normal mail delivery, the Department
encourages you to consider using an alternative delivery method (for example, a
commercial carrier, such as Federal Express or United Parcel Service; U. S. Postal
Service Express Mail; or a courier service) to transmit your application for this
competition to the Department. If you use an alternative delivery method, please
obtain the appropriate proof of mailing under “Applications Sent by Mail,” then
follow the instructions for “Applications Delivered by Hand.”
Applications must be postmarked by the closing date. Only use this address if sending by
courier service (i.e., Fed Ex, UPS, Postal Express), please hand deliver between 8:00 a.m. and
4:30 p.m. to the Application Control Center.
The Application Control Center accepts application deliveries daily between 8:00
a.m. and 4:30 p.m. (Washington, DC time), except Saturdays, Sundays and Federal
holidays.
If you send your application by mail or if you or your courier delivers it by hand, the
Application Control Center will mail a Grant Application Receipt Acknowledgment to
you. If you do not receive the notification of application receipt within 5 days from
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the mailing of the application, you should call the U.S. Department of Education
Application Control Center at (202) 245-6288.
You must indicate on the envelope and—if not provided by the Department—in Item 4 of the
Application for Federal Education Assistance (ED 424 (exp. 11/30/2004)) the CFDA number –
and suffix letter, if any – of the competition under which you are submitting your application.
If your application is late, we will notify you that we will not consider the application.
7/26/04
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Application for Federal U.S.
Department of Education
Form Approved
Education Assistance (ED 424) OMB No. 1875-0106
Exp. 11/30/2004
Address: __________________________________________________________________
_______________________________________________________________________________________________
_______________
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________________________________________________________
11. Proposed Project Dates: ____/____/________ ____/____/_________
Start Date: End Date:
________________________________________________________
_____________________________________________________________ Date:___/____/______
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Instructions for Form ED 424
1. Legal Name and Address. Enter the applicant requirements. Check “No” if
legal name of applicant and the name of you do not meet the requirements for
the primary organizational unit which novice applicants.
will undertake the assistance activity.
7. Federal Debt Delinquency. Check
2. D-U-N-S Number. Enter the “Yes” if the applicant’s organization is
applicant’s D-U-N-S Number. If your delinquent on any Federal debt. (This
organization does not have a D-U-N-S question refers to the applicant’s
Number, you can obtain the number by organization and not to the person
calling 1-800-333-0505 or by who signs as the authorized
completing a D-U-N-S Number representative. Categories of debt
Request Form. The form can be include delinquent audit
obtained via the Internet at the disallowances, loans and taxes.)
following URL: http://www.dnb.com. Otherwise, check “No.”
6. Novice Applicant. Check “Yes” or 12. Human Subjects Research. (See I.A.
“No” only if assistance is being “Definitions” in attached page entitled
requested under a program that gives “Definitions for Form ED 424.”)
special consideration to novice
applicants. Otherwise, leave blank. If Not Human Subjects Research.
Check “No” if research activities
Check “Yes” if you meet the involving human subjects are not
requirements for novice applicants planned at any time during the
specified in the regulations in 34 CFR proposed project period. The
75.225 and included on the attached remaining parts of Item 12 are then not
page entitled “Definitions for Form ED applicable.
424.” By checking “Yes” the applicant
certifies that it meets these novice
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If Human Subjects Research. Check applicant does not have an approved
“Yes” if research activities involving assurance on file with OHRP, enter
human subjects are planned at any time “None.” In this case, the applicant, by
during the proposed project period, signature on the face page, is declaring
either at the applicant organization or that it will comply with 34 CFR 97 and
at any other performance site or proceed to obtain the human subjects
collaborating institution. Check “Yes” assurance upon request by the
even if the research is exempt from the designated ED official. If the
regulations for the protection of human application is recommended/selected
subjects. (See I.B. “Exemptions” in for funding, the designated ED official
attached page entitled “Definitions for will request that the applicant obtain the
Form ED 424.”) assurance within 30 days after the
specific formal request.
12a. If Human Subjects Research is
Exempt from the Human Subjects Note about Institutional Review Board
Regulations. Check “Yes” if all the Approval. ED does not require
research activities proposed are certification of Institutional Review Board
designated to be exempt from the approval with the application. However, if
regulations. Insert the exemption an application that involves non-exempt
number(s) corresponding to one or human subjects research is
more of the six exemption categories recommended/selected for funding, the
listed in I.B. “Exemptions.” In designated ED official will request that the
addition, follow the instructions in II.A. applicant obtain and send the certification
“Exempt Research Narrative” in the to ED within 30 days after the formal
attached page entitled “Definitions for request.
Form ED 424.” Insert this narrative
immediately following the ED 424 face 13. Project Title. Enter a brief descriptive
page. title of the project. If more than one
program is involved, you should
12a. If Human Subjects Research is Not append an explanation on a separate
Exempt from Human Subjects sheet. If appropriate (e.g., construction
Regulations. Check “No” if some or or real property projects), attach a map
all of the planned research activities are showing project location. For
covered (not exempt). In addition, preapplications, use a separate sheet to
follow the instructions in II.B. provide a summary description of this
“Nonexempt Research Narrative” in the project.
page entitled “Definitions for Form ED
424.” Insert this narrative immediately 14. Estimated Funding. Amount
following the ED 424 face page. requested or to be contributed during
the first funding/budget period by each
12a. Human Subjects Assurance contributor. Value of in-kind
Number. If the applicant has an contributions should be included on
approved Federal Wide (FWA) or appropriate lines as applicable. If the
Multiple Project Assurance (MPA) with action will result in a dollar change to
the Office for Human Research an existing award, indicate only the
Protections (OHRP), U.S. Department amount of the change. For decreases,
of Health and Human Services, that enclose the amounts in parentheses. If
covers the specific activity, insert the both basic and supplemental amounts
number in the space provided. If the are included, show breakdown on an
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attached sheet. For multiple program Paperwork Burden Statement. According to the
funding, use totals and show Paperwork Reduction Act of 1995, no persons
are required to respond to a collection of
breakdown using same categories as information unless such collection displays a
item 14. valid OMB control number. The valid OMB
control number for this information collection is
1875-0106. The time required to complete this
15. Certification. To be signed by the information collection is estimated to average
authorized representative of the between 15 and 45 minutes per response,
applicant. A copy of the governing including the time to review instructions, search
body’s authorization for you to sign this existing data resources, gather the data needed,
and complete and review the information
application as official representative collection. If you have any comments concerning
must be on file in the applicant’s office. the accuracy of the estimate(s) or suggestions for
Be sure to enter the telephone and fax improving this form, please write to: U.S.
number and e-mail address of the Department of Education, Washington, D.C.
20202-4651. If you have comments or concerns
authorized representative. Also, in item regarding the status of your individual submission
15e, please enter the month, day, and of this form write directly to: Joyce I. Mays,
four (4) digit year (e.g., 12/12/2001) in Application Control Center, U.S. Department of
Education, 7th and D Streets, S.W. ROB-3,
the date signed field. Room 3671, Washington, D.C. 20202-4725
76
Definitions for Form ED 424
Single Point of Contact. For additional information on
Novice Applicant (See 34 CFR 75.225). For E.O. 12372 go to www.cfda.gov/public/eo12372.htm.
discretionary grant programs under which the
Secretary gives special consideration to novice PROTECTION OF HUMAN SUBJECTS IN
applications, a novice applicant means any applicant RESEARCH
for a grant from ED that—
I. Definitions and Exemptions
• Has never received a grant or subgrant under
A. Definitions.
the program from which it seeks funding;
A research activity involves human subjects if the
• Has never been a member of a group activity is research, as defined in the Department’s
application, submitted in accordance with 34 regulations, and the research activity will involve use
CFR 75.127-75.129, that received a grant of human subjects, as defined in the regulations.
under the program from which it seeks
funding; and —Research
• Has not had an active discretionary grant The ED Regulations for the Protection of Human
Subjects, Title 34, Code of Federal Regulations, Part
from the Federal government in the five
97, define research as “a systematic investigation,
years before the deadline date for
including research development, testing and
applications under the program. For the
evaluation, designed to develop or contribute to
purposes of this requirement, a grant is
generalizable knowledge.” If an activity follows a
active until the end of the grant’s project or
deliberate plan whose purpose is to develop or
funding period, including any extensions of
contribute to generalizable knowledge it is research.
those periods that extend the grantee’s
Activities which meet this definition constitute
authority to obligate funds.
research whether or not they are
In the case of a group application submitted in
conducted or supported under a program which is
accordance with 34 CFR 75.127-75.129, a group
considered research for other purposes. For example,
includes only parties that meet the requirements listed
some demonstration and service programs may
above.
include research activities.
Type of Submission. “Construction” includes —Human Subject
construction of new buildings and acquisition,
expansion, remodeling, and alteration of existing The regulations define human subject as “a living
buildings, and initial equipment of any such buildings, individual about whom an investigator (whether
or any combination of such activities (including professional or student) conducting research obtains
architects’ fees and the cost of acquisition of land). (1) data through intervention or interaction with the
“Construction” also includes remodeling to meet individual, or (2) identifiable private information.”
standards, remodeling designed to conserve energy, (1) If an activity involves obtaining information about
renovation or remodeling to accommodate new a living person by manipulating that person or that
technologies, and the purchase of existing historic person’s environment, as might occur when a new
buildings for conversion to public libraries. For the instructional technique is tested, or by communicating
purposes of this paragraph, the term “equipment” or interacting with the individual, as occurs with
includes machinery, utilities, and built-in equipment surveys and interviews, the definition of human
and any necessary enclosures or structures to house subject is met. (2) If an activity involves obtaining
them; and such term includes all other items necessary private information about a living person in such a
for the functioning of a particular facility as a facility way that the information can be linked to that
for the provision of library services. individual (the identity of the subject is or may be
readily determined by the investigator or associated
Executive Order 12372. The purpose of Executive with the information), the definition of human subject
Order 12372 is to foster an intergovernmental is met. [Private information includes information
partnership and strengthen federalism by relying on about behavior that occurs in a context in which an
State and local processes for the coordination and individual can reasonably expect that no observation
review of proposed Federal financial assistance and or recording is taking place, and information which
direct Federal development. The application notice, as has been provided for specific purposes by an
published in the Federal Register, informs the individual and which the individual can reasonably
applicant as to whether the program is subject to the expect will not be made public (for example, a school
requirements of E.O. 12372. In addition, the health record).]
application package contains information on the State
Single Point of Contact. An applicant is still eligible to B. Exemptions.
apply for a grant or grants even if its respective State,
Territory, Commonwealth, etc. does not have a State
Research activities in which the only involvement of levels of payment for benefits or services under those
human subjects will be in one or more of the following programs.
six categories of exemptions are not covered by the
regulations: (6) Taste and food quality evaluation and consumer
acceptance studies, (a) if wholesome foods without
(1) Research conducted in established or commonly additives are consumed or (b) if a food is consumed
accepted educational settings, involving normal that contains a food ingredient at or below the level
educational practices, such as (a) research on regular and for a use found to be safe, or agricultural chemical
and special education instructional strategies, or (b) or environmental contaminant at or below the level
research on the effectiveness of or the comparison found to be safe, by the Food and Drug Administration
among instructional techniques, curricula, or or approved by the Environmental Protection Agency
classroom management methods. or the Food Safety and Inspection Service of the U.S.
Department of Agriculture.
(2) Research involving the use of educational tests
(cognitive, diagnostic, aptitude, achievement), survey II. Instructions for Exempt and Nonexempt
procedures, interview procedures or observation of Human Subjects Research Narratives
public behavior, unless: (a) information obtained is
recorded in such a manner that human subjects can be If the applicant marked “Yes” for Item 12 on the ED
identified, directly or through identifiers linked to the 424, the applicant must provide a human subjects
subjects; and (b) any disclosure of the human subjects’ “exempt research” or “nonexempt research” narrative
responses outside the research could reasonably place and insert it immediately following the ED 424 face
the subjects at risk of criminal or civil liability or be page.
damaging to the subjects’ financial standing,
employability, or reputation. If the subjects are A. Exempt Research Narrative.
children, exemption 2 applies only to research
involving educational tests and observations of If you marked “Yes” for item 12 a. and designated
public behavior when the investigator(s) do not exemption numbers(s), provide the “exempt research”
participate in the activities being observed. narrative. The narrative must contain sufficient
Exemption 2 does not apply if children are surveyed information about the involvement of human subjects
or interviewed or if the research involves observation in the proposed research to allow a determination by
of public behavior and the investigator(s) participate ED that the designated exemption(s) are appropriate.
in the activities being observed. [Children are defined The narrative must be succinct.
as persons who have not attained the legal age for
consent to treatments or procedures involved in the B. Nonexempt Research Narrative.
research, under the applicable law or jurisdiction in
which the research will be conducted.] If you marked “No” for item 12 a. you must provide
the “nonexempt research” narrative. The narrative
(3) Research involving the use of educational tests must address the following seven points. Although no
(cognitive, diagnostic, aptitude, achievement), survey specific page limitation applies to this section of the
procedures, interview procedures or observation of application, be succinct.
public behavior that is not exempt under section (2)
above, if the human subjects are elected or appointed (1) Human Subjects Involvement and
public officials or candidates for public office; or Characteristics: Provide a detailed description of the
federal statute(s) require(s) without exception that the proposed involvement of human subjects. Describe
confidentiality of the personally identifiable the characteristics of the subject population, including
information will be maintained throughout the their anticipated number, age range, and health status.
research and thereafter. Identify the criteria for inclusion or exclusion of any
subpopulation. Explain the rationale for the
(4) Research involving the collection or study of involvement of special classes of subjects, such as
existing data, documents, records, pathological children, children with disabilities, adults with
specimens, or diagnostic specimens, if these sources disabilities, persons with mental disabilities, pregnant
are publicly available or if the information is recorded women, prisoners, institutionalized individuals, or
by the investigator in a manner that subjects cannot be others who are likely to be vulnerable
identified, directly or through identifiers linked to the
subjects. (2) Sources of Materials: Identify the sources of
research material obtained from individually
(5) Research and demonstration projects which are identifiable living human subjects in the form of
conducted by or subject to the approval of department specimens, records, or data. Indicate whether the
or agency heads, and which are designed to study, material or data will be obtained specifically for
evaluate, or otherwise examine: (a) public benefit or research purposes or whether use will be made of
service programs; (b) procedures for obtaining existing specimens, records, or data.
benefits or services under those programs; (c) possible
changes in or alternatives to those programs or (3) Recruitment and Informed Consent: Describe
procedures; or (d) possible changes in methods or plans for the recruitment of subjects and the consent
procedures to be followed. Include the circumstances
under which consent will be sought and obtained, who (6) Importance of the Knowledge to be Gained:
will seek it, the nature of the information to be Discuss the importance of the knowledge gained or to
provided to prospective subjects, and the method of be gained as a result of the proposed research. Discuss
documenting consent. State if the Institutional Review why the risks to subjects are reasonable in relation to
Board (IRB) has authorized a modification or waiver the anticipated benefits to subjects and in relation to
of the elements of consent or the requirement for the importance of the knowledge that may reasonably
documentation of consent. be expected to result.
(4) Potential Risks: Describe potential risks (physical, (7) Collaborating Site(s): If research involving
psychological, social, legal, or other) and assess their human subjects will take place at collaborating site(s)
likelihood and seriousness. Where appropriate, or other performance site(s), name the sites and briefly
describe alternative treatments and procedures that describe their involvement or role in the research.
might be advantageous to the subjects.
Copies of the Department of Education’s
(5) Protection Against Risk: Describe the procedures Regulations for the Protection of Human Subjects,
for protecting against or minimizing potential risks, 34 CFR Part 97 and other pertinent materials on the
including risks to confidentiality, and assess their protection of human subjects in research are
likely effectiveness. Where appropriate, discuss available from the Grants Policy and Oversight Staff,
provisions for ensuring necessary medical or Office of the Chief Financial Officer, U.S.
professional intervention in the event of adverse Department of Education, Washington, D.C. 20202-
effects to the subjects. Also, where appropriate, 4248, telephone: (202) 708-8263, and on the U.S.
describe the provisions for monitoring the data Department of Education’s Protection of Human
collected to ensure the safety of the subjects. Subjects in Research Web Site at
http://www.ed.gov/about/offices/list/ocfo/humansub.ht
ml
U.S. DEPARTMENT OF EDUCATION OMB Control Number: 1890-0004
BUDGET INFORMATION
Expiration Date: OMB APPROVED
NON-CONSTRUCTION PROGRAMS
Applicants requesting funding for only one year should complete the column under "Project
Name of Institution/Organization
Year 1." Applicants requesting funding for multi-year grants should complete all applicable
columns. Please read all instructions before completing form.
1. Personnel
2. Fringe Benefits
3. Travel
4. Equipment
5. Supplies
6. Contractual
7. Construction
8. Other
Project Year 1 Project Year 2 Project Year 3 Project Year 4 Project Year 5 Total
Budget Categories (a) (b) (c) (d) (e) (f)
1. Personnel
2. Fringe Benefits
3. Travel
4. Equipment
5. Supplies
6. Contractual
7. Construction
8. Other
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040),
Washington, DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions,
please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to
certify to additional assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal Treatment Act of 1972 (P.L. 92-255), as amended,
assistance, and the institutional, managerial and relating to nondiscrimination on the basis of drug
financial capability (including funds sufficient to pay abuse; (f) the Comprehensive Alcohol Abuse and
the non-Federal share of project cost) to ensure Alcoholism Prevention, Treatment and Rehabilitation
proper planning, management, and completion of the Act of 1970 (P.L. 91-616), as amended, relating to
project described in this application. nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) §§ 523 and 527 of the Public Health
2. Will give the awarding agency, the Comptroller Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290
General of the United States, and if appropriate, the ee 3), as amended, relating to confidentiality of
State, through any authorized representative, access alcohol and drug abuse patient records; (h) Title VIII
to and the right to examine all records, books, papers, of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et
or documents related to the award; and will establish seq.), as amended, relating to nondiscrimination in
a proper accounting system in accordance with the sale, rental or financing of housing; (i) any other
generally accepted accounting standards or agency nondiscrimination provisions in the specific statute(s)
directives. under which application for Federal assistance is
being made; and (j) the requirements of any other
3. Will establish safeguards to prohibit employees from nondiscrimination statute(s) which may apply to the
using their positions for a purpose that constitutes or application.
presents the appearance of personal or organizational
conflict of interest, or personal gain.
7. Will comply, or has already complied, with the
4. Will initiate and complete the work within the requirements of Titles II and III of the uniform
applicable time frame after receipt of approval of the Relocation Assistance and Real Property Acquisition
awarding agency. Policies Act of 1970 (P.L. 91-646)
which provide for fair and equitable treatment of
5. Will comply with the Intergovernmental Personnel persons displaced or whose property is acquired as a
Act of 1970 (42 U.S.C. §§4728-4763) relating to result of Federal or federally assisted programs.
prescribed standards for merit systems for programs These requirements apply to all interests in real
funded under one of the 19 statutes or regulations property acquired for project purposes regardless of
specified in Appendix A of OPM's Standards for a Federal participation in purchases.
Merit System of Personnel Administration (5 C.F.R.
900, Subpart F). 8. Will comply, as applicable, with the provisions of the
Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)
6. Will comply with all Federal statutes relating to which limit the political activities of employees
nondiscrimination. These include but are not limited whose principal employment activities are funded in
to: (a) Title VI of the Civil Rights Act of 1964 (P.L. whole or in part with Federal funds.
88-352) which prohibits discrimination on the basis
of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20
U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c)
Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits
discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C.
§§ 6101-6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and
9. Will comply, as applicable, with the provisions of the 12 Will comply with the Wild and Scenic Rivers Act of
Davis-Bacon Act (40 U.S.C. §§276a to 276a-7), the 1968 (16 U.S.C. §§1721 et seq.) related to protecting
Copeland Act (40 U.S.C. §276c and 18 U.S.C. components or potential components of the national
§§874) and the Contract Work Hours and Safety wild and scenic rivers system.
Standards Act (40 U.S.C. §§ 327-333), regarding
labor standards for federally assisted construction 13. Will assist the awarding agency in assuring
subagreements. compliance with Section 106 of the National
Historic Preservation Act of 1966, as amended (16
10. Will comply, if applicable, with flood insurance U.S.C. §470), EO 11593 (identification and
purchase requirements of Section 102(a) of the Flood protection of historic properties), and the
Disaster Protection Act of 1973 (P.L. 93-234) which Archaeological and Historic Preservation Act of 1974
requires recipients in a special flood hazard area to (16 U.S.C. §§469a-1 et seq.).
participate in the program and to purchase flood
insurance if the total cost of insurable construction 14. Will comply with P.L. 93-348 regarding the
and acquisition is $10,000 or more. protection of human subjects involved in research,
development, and related activities supported by this
11. Will comply with environmental standards which award of assistance.
may be prescribed pursuant to the following: (a)
institution of environmental quality control measures 15. Will comply with the Laboratory Animal Welfare Act
under the National Environmental Policy Act of 1969 of 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131
(P.L. 91-190) and Executive Order (EO) 11514; (b) et seq.) pertaining to the care, handling, and
notification of violating facilities pursuant to EO treatment of warm blooded animals held for research,
11738; (c) protection of wetlands pursuant to EO teaching, or other activities supported by this award
11990; (d) evaluation of flood hazards in floodplains of assistance.
in accordance with EO 11988; (e) assurance of
project consistency with the approved State 16. Will comply with the Lead-Based Paint Poisoning
management program developed under the Coastal Prevention Act (42 U.S.C. §§4801 et seq.) which
Zone Management Act of 1972 (16 U.S.C. §§1451 et prohibits the use of lead- based paint in construction
seq); (f) conformity of Federal actions to State (Clear or rehabilitation of residence structures.
Air) Implementation Plans under Section 176(c) of
the Clear Air Act of 1955, as amended (42 U.S.C. 17. Will cause to be performed the required financial and
§§7401 et seq.); (g) protection of underground compliance audits in accordance with the Single
sources of drinking water under the Safe Drinking Audit Act Amendments of 1996 and OMB Circular
Water Act of 1974, as amended, (P.L. 93-523); and No. A-133, “Audits of States, Local Governments,
(h) protection of endangered species under the and Non-Profit Organizations.”
Endangered Species Act of 1973, as amended, (P.L.
93-205). 18. Will comply with all applicable requirements of all
other Federal laws, executive orders, regulations and
policies governing this program.
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for
persons entering into a Federal contract, grant or cooperative agreement over $100,000, as
defined at 34 CFR Part 82, Sections 82.105 and 82.110, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the making of any Federal grant, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of
any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal grant or cooperative agreement, the undersigned shall complete and
submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions;
(c) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subgrants and contracts under grants and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
As the duly authorized representative of the applicant, I hereby certify that the applicant will
comply with the above certification.
SIGNATURE DATE
ED 80-0013
06/04
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion -- Lower Tier Covered Transactions
This certification is required by the Department of Education regulations implementing Executive Order 12549, Debarment
and Suspension, 34 CFR Part 85, for all lower tier transactions meeting the threshold and tier requirements stated at
Section 85.110.
Instructions for Certification 6. The prospective lower tier participant further agrees
by submitting this proposal that it will include the clause
1. By signing and submitting this proposal, the titled Certification Regarding Debarment, Suspension,
prospective lower tier participant is providing the Ineligibility, and Voluntary Exclusion-Lower Tier
certification set out below. Covered Transactions,without modification, in all lower
tier covered transactions and in all solicitations for lower
2. The certification in this clause is a material tier covered transactions.
representation of fact upon which reliance was placed
when this transaction was entered into. If it is later 7. A participant in a covered transaction may rely upon
determined that the prospective lower tier participant a certification of a prospective participant in a lower tier
knowingly rendered an erroneous certification, in covered transaction that it is not debarred, suspended,
addition to other remedies available to the Federal ineligible, or voluntarily excluded from the covered
Government, the department or agency with which this transaction, unless it knows that the certification is
transaction originated may pursue available remedies, erroneous. A participant may decide the method and
including suspension and/or debarment. frequency by which it determines the eligibility of its
principals. Each participant may but is not required to,
3. The prospective lower tier participant shall provide check the Nonprocurement List.
immediate written notice to the person to which this
proposal is submitted if at any time the prospective 8. Nothing contained in the foregoing shall be
lower tier participant learns that its certification was construed to require establishment of a system of
erroneous when submitted or has become erroneous records in order to render in good faith the certification
by reason of changed circumstances. required by this clause. The knowledge and information
of a participant is not required to exceed that which is
4. The terms "covered transaction," "debarred," normally possessed by a prudent person in the ordinary
"suspended," "ineligible," "lower tier covered course of business dealings.
transaction," "participant," " person," "primary covered
transaction," " principal," "proposal," and "voluntarily 9. Except for transactions authorized under paragraph
excluded," as used in this clause, have the meanings 5 of these instructions, if a participant in a covered
set out in the Definitions and Coverage sections of rules transaction knowingly enters into a lower tier covered
implementing Executive Order 12549. You may contact transaction with a person who is suspended, debarred,
the person to which this proposal is submitted for ineligible, or voluntarily excluded from participation in
assistance in obtaining a copy of those regulations. this transaction, in addition to other remedies available
to the Federal Government, the department or agency
5. The prospective lower tier participant agrees by with which this transaction originated may pursue
submitting this proposal that, should the proposed available remedies, including suspension and/or
covered transaction be entered into, it shall not debarment.
knowingly enter into any lower tier covered transaction
with a person who is debarred, suspended, declared
ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by the
department or agency with which this transaction
originated.
Certification
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals
are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this proposal.
SIGNATURE DATE
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name
____ Prime _____ Subawardee and Address of Prime:
Tier______, if Known:
$
10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if
(if individual, last name, first name, MI): different from No. 10a)
(last name, first name, MI):
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient,
at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title
31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any
lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a
covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer
to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to
influence the outcome of a covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material
change to the information previously reported, enter the year and quarter in which the change occurred.
Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional
District, if known. Check the appropriate classification of the reporting entity that designates if it is, or
expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first
subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts,
subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address,
city, State and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one
organizational level below agency name, if known. For example, Department of Transportation, United
States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter
the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements,
loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item
1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement
number; the contract, grant, or loan award number; the application/proposal control number assigned by
the Federal agency). Included prefixes, e.g., “RFP-DE-90-001.”
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,
enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying
Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered
Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different
from 10(a). Enter Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information
unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No.
0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response,
including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget,
Paperwork Reduction Project (0348-0046), Washington, DC 20503
Section F
Important Notices
IMPORTANT POINTS TO REMEMBER IN PREPARING APPLICATION
FOR POSITIVE PSYCHOLOGY—84.235A
• Be certain to read the entire application kit, including the “Dear Applicant Letter”.
• Please note that the specific selection criteria are listed in this package.
• Number all pages to make it easier for the reader to refer to a page number if
comments are given (including the appendices).
Supplies - Direct materials and supplies that are consumable, expendable and of a
relatively low unit cost.
Key Personnel - The personnel category of the budget includes all project staff
members who are employees of the applicant. However, KEY PERSONNEL are
defined as the Project Director, Principle Investigator, and Project Coordinator.
Other - Where applicants may place all direct costs that are not clearly covered by the
other direct cost categories. It is a catch-all category that could include a wide variety
of costs that do not seem to "fit" elsewhere in the budget.
Indirect Costs—Indirect costs are limited to the recipient’s actual negotiated indirect
cost rate, or 10% of the total direct cost base, whichever amount is less. (This limit
does not apply to federally recognized Indian tribal governments.) (§373.4)
• In the narrative address the needs of individuals with disabilities from minority
backgrounds (Section 21 of the Act).
• In the narrative address the availability and purposes of the State Client Assistance
Program (CAP), including information on means of seeking assistance under such
program. (Section 20 of the Act)
• Please read the REGULATIONS (34 CFR 373) included in this application.
• Try to keep the narrative to 35 pages, double-spaced. The one-page abstract may be
single-spaced.
• Application must be postmarked by the closing date. Only use this address if
sending by courier service (i.e., Fed Ex, UPS, Postal Express), please hand deliver
between 8:00 a.m. and 4:30 p.m., to the following address: U.S. Department of
Education, Application Control Center, Room 7041, Potomac Center Plaza, 550 12th
Street S.W., Washington, D.C. 20202-4260. Telephone number: (202) 245-6288.
OMB Control No. 1890-0007 (Exp. 09/30/2004)
NOTICE TO ALL APPLICANTS
The purpose of this enclosure is to inform you circumstances. In addition, the information may
about a new provision in the Department of be provided in a single narrative, or, if
Education's General Education Provisions Act appropriate, may be discussed in connection with
(GEPA) that applies to applicants for new grant related topics in the application.
awards under Department programs. This
provision is Section 427 of GEPA, enacted as Section 427 is not intended to duplicate the
part of the Improving America's Schools Act of requirements of civil rights statutes, but rather to
1994 (Public Law (P.L.) 103-382). ensure that, in designing their projects,
applicants for Federal funds address equity
To Whom Does This Provision Apply? concerns that may affect the ability of certain
potential beneficiaries to fully participate in the
Section 427 of GEPA affects applicants for new project and to achieve to high standards.
grant awards under this program. ALL Consistent with program requirements and its
APPLICANTS FOR NEW AWARDS MUST approved application, an applicant may use the
INCLUDE INFORMATION IN THEIR Federal funds awarded to it to eliminate barriers
APPLICATIONS TO ADDRESS THIS NEW it identifies.
PROVISION IN ORDER TO RECEIVE
FUNDING UNDER THIS PROGRAM. What are Examples of How an Applicant
Might Satisfy the Requirement of This
(If this program is a State-formula grant Provision?
program, a State needs to provide this
description only for projects or activities that it The following examples may help illustrate how
carries out with funds reserved for State-level an applicant may comply with Section 427.
uses. In addition, local school districts or other
eligible applicants that apply to the State for (1) An applicant that proposes to carry out
funding need to provide this description in their an adult literacy project serving, among
applications to the State for funding. The State others, adults with limited English
would be responsible for ensuring that the school proficiency, might describe in its application
district or other local entity has submitted a how it intends to distribute a brochure about
sufficient section 427 statement as described the proposed project to such potential
below.) participants in their native language.
What Does This Provision Require? (2) An applicant that proposes to develop
instructional materials for classroom use
Section 427 requires each applicant for funds might describe how it will make the
(other than an individual person) to include in its materials available on audio tape or in
application a description of the steps the braille for students who are blind.
applicant proposes to take to ensure equitable
access to, and participation in, its Federally- (3) An applicant that proposes to carry out a
assisted program for students, teachers, and other model science program for secondary
program beneficiaries with special needs. This students and is concerned that girls may be
provision allows applicants discretion in less likely than boys to enroll in the course,
developing the required description. The statute might indicate how it intends to conduct
highlights six types of barriers that can impede "outreach" efforts to girls, to encourage their
equitable access or participation: gender, race, enrollment.
national origin, color, disability, or age. Based
on local circumstances, you should determine We recognize that many applicants may already
whether these or other barriers may prevent your be implementing effective steps to ensure equity
students, teachers, etc. from such access or of access and participation in their grant
participation in, the Federally-funded project or programs, and we appreciate your cooperation in
activity. The description in your application of responding to the requirements of this provision.
steps to be taken to overcome these barriers need
not be lengthy; you may provide a clear and
succinct description of how you plan to address
those barriers that are applicable to your
Estimated Burden Statement for GEPA Requirements
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless such collection displays a valid OMB control number. The valid OMB control number
for this information collection is 1890-0007. The time required to complete this information collection is
estimated to average 1.5 hours per response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and review the information collection.
If you have any comments concerning the accuracy of the time estimate(s) or suggestions for
improving this form, please write to: Director, Grants Policy and Oversight Staff, U.S. Department of
Education, 400 Maryland Avenue, SW (Room 3652, GSA Regional Office Building No. 3), Washington,
DC 20202-4248.
THE GOVERNMENT PERFORMANCE AND RESULTS ACT
(GPRA)
What is GPRA
The Government Performance and Results Act of 1993 is a straightforward
statute that requires all Federal agencies to manage their activities with
attention to the consequences of those activities. Each agency is to clearly
state what intends to accomplish, identify the resources required, and
periodically report their progress to the Congress. In doing so, it is
expected that GPRA will contribute to improvements in accountability for
the expenditures of public funds, improve Congressional decision-making
through more objective information on the effectiveness of Federal
programs, and promote a new government focus on results, service
delivery, and customer satisfaction.
It is estimated that in 2004 the Federal Government will outlay $400 billion
in grants to State and local governments. Executive Order 12372,
"Intergovernmental Review of Federal Programs," was issued with the desire to
foster the intergovernmental partnership and strengthen federalism by relying on
State and local processes for the coordination and review of proposed Federal
financial assistance and direct Federal development. The Order allows each
State to designate an entity to perform this function. Below is the official list of
those entities. For those States that have a home page for their designated
entity, a direct link has been provided on the official version:
http://www.whitehouse.gov/omb/grants/spoc.html.
States that are not listed on this page have chosen not to participate in the
intergovernmental review process, and therefore do not have a SPOC. If you are
located within one of these States, you may still send application materials
directly to a Federal awarding agency.
Contact information for Federal agencies that award grants can be found
in Appendix IV of the Catalog of Federal Domestic Assistance.
[www.cfda.gov/public/cat-app4-index.htm]
ARKANSAS CALIFORNIA
Tracy L. Copeland Grants Coordination
Manager, State Clearinghouse State Clearinghouse
Office of Intergovernmental Services Office of Planning and Research
Department of Finance and Administration P.O. Box 3044, Room 222
1515 W. 7th Street, Room 412 Sacramento, California 95812-3044
Little Rock, Arkansas 72203 Telephone: (916) 445-0613
Telephone: (501) 682-1074 FAX: (916) 323-3018
FAX: (501) 682-5206 State.clearinghouse@opr.ca.gov
Tlcopeland@dfa.state.ar.us
DELAWARE DISTRICT OF COLUMBIA
Sandra R. Stump Luisa Montero-Diaz
Executive Department Office of Partnerships and Grants
Office of the Budget Development
540 S. Dupont Highway , 3rd Floor Executive Office of the Mayor
Dover, Delaware 19901 District of Columbia Government
Telephone: (302) 739-3323 414 4th Street, NW, Suite 530 South
FAX: (302) 739-5661 Washington, DC 20001
Sandy.stump@state.de.us Telephone: (202) 727-8900
FAX: (202) 727-1652
opgd.eom@dc.gov
FLORIDA GEORGIA
Lauren P. Milligan Barbara Jackson
Florida State Clearinghouse Georgia State Clearinghouse
Florida Dept. of Environmental Protection 270 Washington Street, SW
3900 Commonwealth Blvd., Mall Station Atlanta, Georgia 30334
47 Telephone: (404) 656-3855
Tallahassee, Florida 32399-3000 FAX: (404) 656-7901
Telephone: (850) 245-2161 gach@mail.opb.state.ga.us
FAX: (850) 245-2190
Lauren.Milligan@dep.state.fl.us
ILLINOIS IOWA
Roukaya McCaffrey Steven R. McCann
Department of Commerce and Division of Community and Rural
Economic Opportunities Development
620 East Adams, 6th Floor Iowa Department of Economic
Springfield, Illinois, 62701 Development
Telephone: (217) 524-0188 200 East Grand Avenue
FAX: (217) 558-0473 Des Moines, Iowa 50309
roukaya_mccaffrey@illinoisbiz.biz Telephone: (515) 242-4719
FAX: (515) 242-4809
Steve.mccann@ided.state.ia.us
KENTUCKY MAINE
Ron Cook Joyce Benson
Department for Local Government State Planning Office
1024 Capital Center Drive, Suite 340 184 State Street
Frankfort, Kentucky 40601 38 State House Station
Telephone: (502) 573-2382 Augusta, Maine 04333
FAX: (502) 573-2512 Telephone: (207) 287-3261
ron.cook@mail.state.ky.us Telephone: (207) 1461
FAX: (207) 287-6489
joyce.benson@state.me.us
MARYLAND
Linda C. Janey, J.D.
Director, Capital Plng. & Devel. Review
Maryland Department of Planning
301 West Preston Street – Room 1104
Baltimore, Maryland 21201-2305
Telephone: (410) 767-4490
FAX: (410) 767-4480
ljaney@mdp.state.md.us
MICHIGAN MISSISSIPPI
Richard Pfaff Cathy Mallette
Southeast Michigan Council of Clearinghouse Officer
Governments Department of Finance and Administration
535 Griswold, Suite 300 1301 Woolfolk Building, Suite E
Detroit, Michigan 48226 501 North West Street
Telephone: (313) 961-4266 Jackson, Mississippi 39201
FAX: (313) 961-4869 Telephone: (601) 359-6762
pfaff@semcog.org Fax: (601) 359-6758
MISSOURI NEVADA
Angela Boessen Heather Elliott
Federal Assistance Clearinghouse Department of Administration
Office of Administration State Clearinghouse
P.O. Box 809 209 E. Musser Street, Room 200
Truman Building, Room 840 Carson City, Nevada 89701
Jefferson City, Missouri 65102 Telephone: (775) 684-0209
Telephone: (573) 751-4834 FAX: (775) 684-0260
FAX: (573) 522-4395 helliot@govmail.state.nv.us
igr@mail.oa.state.mo.us
NEW HAMPSHIRE NEW MEXICO
Jeffrey H. Taylor Ken Hughes
Director, New Hampshire Office of State Local Government Division
Planning Room 201, Bataan Memorial Building
Attn: Intergovernmental Review Process Santa Fe, New Mexico 87503
Mike Blake Telephone: (505) 827-4370
2½ Beacon Street FAX: (505) 827-4948
Concord, New Hampshire 03301 khughes@dfa.state.nm.us
Telephone: (603) 271-2155
FAX: (603) 271-1728
jtaylor@osp.state.nh.us
NEW YORK NORTH DAKOTA
Linda Shkrell Jim Boyd
Office of Public Security Division of Community Services
Homeland Security Grants Coordination 600 East Boulevard Ave, Dept 105
633 3rd Avenue Bismarck, North Dakota 58505-0170
New York, NY 10017 Telephone: (701) 328-2094
Telephone: (212) 867-1289 FAX: (701) 328-2308
FAX: (212) 867-1725 jboyd@state.nd.us
RHODE ISLAND SOUTH CAROLINA
Kevin Nelson SC Clearinghouse
Department of Administration Budget and Control Board
Statewide Planning Program Office of State Budget
One Capitol Hill 1201 Main Street, Suite 950
Providence Rhode Island 02908-5870 Columbia, South Carolina 29201
Telephone: (401) 222-2093 Telephone: (803) 734-0494
FAX: (401) 222-2083 FAX: (803) 734-0645
knelson@doa.state.ri.us clearinghouse@budget.state.sc.us
TEXAS UTAH
Denise S. Francis Clare Walters
Director, State Grants Team Utah State Clearinghouse
Governor’s Office of Budget and Planning Governor’s Office of Planning and Budget
P.O. Box 12428 State Capitol, Room 116
Austin, Texas 78711 Salt Lake City, Utah 84114
Telephone: (512) 305-9415 Telephone: (801) 538-1555
FAX: (512) 936-2681 FAX: (801) 538-1547
dfrancis@governor.state.tx.us cwalters@gov.state.ut.us
WEST VIRGINIA WISCONSIN
Fred Cutlip, Director Jeff Smith
Community Development Division Section Chief, Federal/State Relations
West Virginia Development Office Wisconsin Department of Administration
Building #6, Room 553 101 East Wilson Street – 6th Floor
Charleston, West Virginia 25305 P.O. Box 7868
Telephone: (304) 558-4010 Madison, Wisconsin 53707
FAX: (304) 558-3248 Telephone: (608) 266-0267
fcutlip@wvdo.org FAX: (608) 267-6931
jeffrey.smith@doa.state.wi.us
AMERICAN SAMOA GUAM
Pat M. Galea'i Director
Federal Grants/Programs Coordinator Bureau of Budget and Mgmt. Research
Office of Federal Programs/Office of the Office of the Governor
Governor P.O. Box 2950
Department of Commerce Agana, Guam 96910
American Samoa Government Telephone: 011-671-472-2285
Pago Pago, American Samoa 96799 FAX: 011-671-472-2825
Telephone: (684) 633-5155 jer@ns.gov.gu
Fax: (684) 633-4195
pmgaleai@samoatelco.com
PUERTO RICO NORTH MARIANA ISLANDS
Jose Caballero / Mayra Silva Ms. Jacoba T. Seman
Puerto Rico Planning Board Federal Programs Coordinator
Federal Proposals Review Office Office of Management and Budget
Minillas Government Center Office of the Governor
P.O. Box 41119 Saipan, MP 96950
San Juan, Puerto Rico 00940-1119 Telephone: (670) 664-2289
Telephone: (787) 723-6190 FAX: (670) 664-2272
FAX: (787) 722-6783 omb.jseman@saipan.com
VIRGIN ISLANDS
Ira Mills
Director, Office of Management and
Budget
# 41 Norre Gade Emancipation Garden
Station,
Second Floor
Saint Thomas, Virgin Islands 00802
Telephone: (340) 774-0750
FAX: (787) 776-0069
Irmills@usvi.org
Changes to this list can be made only after OMB is notified by a State’s
officially designated representative. E-mail messages can be sent to
grants@omb.eop.gov. If prefer, you may send correspondence to the following
postal address:
Purpose: This form is for applicants that are nonprofit private organizations (not including private universities). Please complete
it to assist the Federal government in ensuring that all qualified applicants, small or large, non-religious or faith-based, have an
equal opportunity to compete for Federal funding. Information provided on this form will not be considered in any way in making
funding decisions and will not be included in the Federal grants database.
Instructions for Submitting Survey
If submitting hard copy, please place the completed survey in an envelope labeled “Applicant Survey.” Seal the envelope and include
it with your application package.
2. For example, two part-time employees who each work half-time equal one full-time
equivalent employee. If the applicant is a local affiliate of a national organization, the
responses to survey questions 2 and 3 should reflect the staff and budget size of the
local affiliate.
3. Annual budget means the amount of money your organization spends each year on all
of its activities.
4. Self-identify.
7. Self-explanatory.
8. Self-explanatory.
Paperwork Burden Statement
Applicants for grants from the U.S. Department of Education (ED) have to compete for limited
funds. Deadlines assure all applicants that they will be treated fairly and equally, without last
minute haste. For these reasons, ED must set strict deadlines for grant applications. Prospective
applicants can avoid disappointment if they understand that:
Failure to meet a deadline will mean that an applicant will be rejected without any
consideration.
The rules, including the deadline, for applying for each grant are published, individually, in the
Federal Register. A one-year subscription to the Register may be obtained by sending $555.00
to: Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402-
9371. (Send check or money order only, no cash or stamps.) In addition, the Federal Register is
available on-line for free on Government Printing Office (GPO) Access:
www.gpoaccess.gov/fr/index.html. Depository Library location and Federal Register services:
http://www.archives.gov/.
The instructions in the Federal Register must be followed exactly. Do not accept any other advice
you may receive. No ED employee is authorized to extend any deadline published in the
Register. No ED employees are authorized to extend any deadline published in the Federal
Register. Questions regarding submission of applications may be addressed to:
CONTRACTS
Competitive procurement actions undertaken by the ED are governed by the Federal Acquisition
Regulations and implementing Department of Education Acquisition Regulations.
Offerors are advised to be guided solely by the contents of the CBD synopsis and the instructions
contained in the RFP. Questions regarding the submission of offers should be addressed to the
Contracts Specialist identified on the face page of the RFP. Offers are judged in competition with
others, and failure to conform with any substantive requirements of the RFP will result in rejection
of the offer without any consideration whatever.
Do not accept any advice you receive that is contrary to instructions contained in either the CBD
synopsis or the RFP. No ED employee is authorized to consider a proposal which is non-
responsive to the RFP. A subscription to the CBD is available for $208.00 per year via second
class mailing or $261.00 per year via first class mailing. Information included in the Federal
Acquisition Regulation is contained in Title 48, Code of Federal Regulations, Chapter 1 ($49.00).
The foregoing publication may be obtained by sending your check or money order only, no cash
or stamps, to:
Superintendent of Documents
U.S. Government Printing Office
Washington, D.C. 20402-9371
In addition, the Commerce Business Daily is available on-line for free at the following
UNITED STATES DEPARTMENT OF EDUCATION
REHABILITATION SERVICES ADMINISTRATION
REGIONAL OFFICE DIRECTORY
REGION I REGION II
Allen Kropp Allen Kropp
RSA Regional Commissioner-01 RSA Regional Commissioner-02
U.S. Department of Education/OSERS U.S. Department of Education/OSERS
J.W. McCormack Post Office 75 Park Place, 12th Floor
& Court House, Room 232 New York, NY 10007
Boston, Massachusetts 02109 PHONE: (212) 264-4016
PHONE: (617) 223-4085 FAX: (212) 264-3029
FAX: (617) 223-4573 TTY: (800) 437-0833
TTY: (617) 223-4097 E-MAIL: allen.kropp@ed.gov
E-MAIL: allen.kropp@ed.gov -- New Jersey
-- Connecticut -- New York
-- Maine -- Puerto Rico
-- Massachusetts -- Virgin Island
-- New Hampshire
-- Rhode Island
-- Vermont
Application Checklist,
Common Questions and Answers, and
Other Important Information
APPLICATION CHECKLIST
[] Budget narrative
Did You --
* Application must be postmarked by the closing date. Only use this address if
sending by courier service (i.e., Fed Ex, UPS, Postal Express), please hand deliver
between 8:00 a.m. and 4:30 p.m., to the following address: U.S. Department of
Education, Application Control Center, Room 7067, Potomac Center Plaza, 550 12th
Street S.W., Washington, D.C. 20202-4260. Telephone number: (202) 245-6288.
[Below are some examples of Q's & A's that programs may include in
their application booklets. Programs may want to add others.
Generally speaking, Q's & A's should not repeat information that is
given elsewhere in the application. However, there may be
exceptions to this "rule of thumb." Q's & A's should not be
subregulatory and should not take the place of instructions.]
A. Invitational Priority
Competitive Priority
Absolute Priority
www.dnb.com/dbis/about/intlduns.htm
The D-U-N-S Number is a unique nine-digit number that does not convey any
information about the recipient. A built in check digit helps assure the accuracy of
the D-U-N-S Number. The ninth digit of each number is the check digit, which is
mathematically related to the other digits. It lets computer systems determine if a
D-U-N-S Number has been entered correctly.
Dun & Bradstreet, a global information services provider, has assigned D-U-N-S
number to over 43 million companies worldwide.
GRANT APPLICATION RECEIPT ACKNOWLEDGMENT
If you fail to receive the notification of application receipt within fifteen (15) days
from the closing date, call: